Active NPI
Karissa Boodhoo, PHARMD
- Pharmacist
- Jackson Heights, NY
National Provider Identifier
1982292454
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 067567
- Practice address
- 3766 82ND St
Jackson Heights, NY 11372-7006 - Phone
- (718) 507-8056
- NPI assigned
- Jan 9, 2021
- Last updated
- Mar 15, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 067567 | NY | Primary |
Addresses
Primary practice location
3766 82ND St
Jackson Heights, NY 11372-7006
Mailing address
8026 260TH St
Floral Park, NY 11004-1202
Phone (718) 598-1461
Other practice location 1
3506 Broadway
Astoria, NY 11106-1114
Phone (715) 204-5253
Other practice location 2
1338 Broadway
Hewlett, NY 11557-2113
Phone (516) 295-6830
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 067567 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Duane Reade | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
3766 82nd St
Jackson Heights, NY 11372
Phone (718) 507-8056
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1610150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647302400000",
"number": "1982292454",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8026 260TH ST",
"city": "FLORAL PARK",
"state": "NY",
"postal_code": "110041202",
"telephone_number": "718-598-1461",
"fax_number": "718-343-1846"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3766 82ND ST",
"city": "JACKSON HEIGHTS",
"state": "NY",
"postal_code": "113727006",
"telephone_number": "718-507-8056"
}
],
"practiceLocations": [
{
"address_1": "3506 Broadway",
"address_purpose": "LOCATION",
"city": "Astoria",
"state": "NY",
"postal_code": "111061114",
"country_code": "US",
"telephone_number": "715-204-5253",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1338 Broadway",
"address_purpose": "LOCATION",
"city": "Hewlett",
"state": "NY",
"postal_code": "115572113",
"country_code": "US",
"telephone_number": "516-295-6830",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BOODHOO",
"first_name": "KARISSA",
"name_prefix": "Ms.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-01-09",
"last_updated": "2022-03-15",
"certification_date": "2021-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "067567",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson Heights, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.